Volume 48, Issue 5 p. 560-566

Update on Electroconvulsive Therapy (ECT) in Older Adult

Karen G. Kelly MD

Karen G. Kelly MD

Temple University School of Medicine, Philadelphia, Pennsylvania.

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Marc Zisselman MD

Corresponding Author

Marc Zisselman MD

Temple University School of Medicine, Philadelphia, Pennsylvania.

Temple Continuing Care Center, 5301 Old York Rd., Philadelphia, PA 19141.Search for more papers by this author
First published: 27 April 2015
Citations: 60

Abstract

Electroconvulsive therapy (ECT) is used increasingly in the older adult population for major depression, particularly when depression is not responsive to medications, when antidepressants are not tolerated due to side effects, or when depression is accompanied by life-threatening complications such as severe weight loss or catatonia where a rapid definitive response is required. ECT is considered a low-risk procedure that can be successfully done in medically ill older adults, but it is associated with a brief period of increased blood pressure and pulse leading to increased myocardial oxygen demand. ECT may cause delirium, particularly in the cognitively impaired older. As successful management of older patients undergoing a course of ECT often involves geriatricians and other medical practitioners, this review provides an update on the indications for ECT, how it is done, the common complications seen after the procedure, and its efficacy. Finally, specific recommendations for management are made. J Am Geriatr Soc 48: 560–566, 2000.